Radv Audit Jobs (NOW HIRING)

The VP, Internal Audit is a highly visible senior leadership role responsible for directing the internal audit function at Alignment Healthcare, Inc., with accountability for SOX compliance, enterprise risk management, and regulatory oversight across all business operations. This leader works in close partnership with the Audit Committee, CFO, CAO, executive leadership, legal, compliance, finance, and business unit leaders to strengthen the overall control environment and position internal audit as a trusted advisor—not merely a compliance function. Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces emerging risks, and ensures the organization operates with the highest standards of accountability. This is a critical enterprise function whose outcomes directly protect patients, maintain regulatory standing, and support the organization's mission of delivering high-quality, cost-effective care to Medicare Advantage-enrolled seniors.Job Duties / Responsibilities Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness, and encounter data integrity.Apply strong executive presence and communication skills to translate audit data into strategic insights for the Board and senior leadership. Supervisory Responsibilities This role carries supervisory responsibility over the Company's third-party external audit team, including oversight of quality, work standards, timelines, reporting, and cost management. Supervisory Requirements: Fulfill supervisory responsibilities in accordance with organization policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.Job Requirements Experience 15+ years of progressive internal audit, external audit, or financial controls experience, with at least 5 years in a senior leadership role 8+ years of experience with a publicly traded company, including demonstrated knowledge of SEC reporting requirements and PCAOB auditing standards Deep expertise in Medicare Advantage plans, risk adjustment, and healthcare operations, including familiarity with CMS regulations, RADV, and the Model Audit Rule Experience leading audit work in complex, regulated healthcare or insurance environments with strong emphasis on SOX and COSO framework application Demonstrated experience directing and governing outsourced or co-sourced audit partnerships, including vendor management and quality oversight Experience supporting Audit Committee reporting and direct interaction with Board-level governance bodies Prior experience at a Big 4 public accounting firm or national advisory firm within a healthcare or managed care practice Education Demonstrated working knowledge of PCAOB standards, SEC reporting requirements, and SOX Section 404 implementation Skills & Competencies Technical / Role-Specific Skills : In-depth knowledge of CMS regulations, risk adjustment methodology, RADV audit processes, encounter data integrity, and the Model Audit Rule as they apply to Medicare Advantage health plans **Enterprise Risk Management (Advanced)**: Ability to design and execute risk-based audit plans that address financial, operational, IT, and regulatory risks across complex, multi-functional organizations; fluency with COSO ERM framework **IT General Controls & Systems Audit (Intermediate to Advanced)**: Working knowledge of IT general controls, ERP control environments, data migration oversight, and systems implementation auditing—particularly in claims, pharmacy, and financial systems : Exceptional written and verbal communication skills; ability to translate complex audit findings into concise, strategic narratives for Board-level and C-suite audiences while maintaining full independence from management decision-making : Familiarity with audit analytics tools (e.g., ACL, IDEA, Tableau, or similar) to enhance audit coverage, identify anomalies, and improve audit efficiency across large data sets common in healthcare and claims environments.Certified Internal Auditor (CIA) — preferred; the global standard for internal audit professionals, demonstrating proficiency in IIA Standards, risk management, and governanceCertified Information Systems Auditor (CISA) — preferred, particularly given the IT controls and ERP oversight responsibilities of this roleWhile performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. #J-18808-Ljbffr